Adult day care facilities are an important provider node through which a significant portion of the community-dwelling older population receives care. Adult day care has emerged as an increasingly important strategy that enables older people to receive needed services and remain in the community and retain as much independence as possible. Yet, the extent to which this service modality is responsive to the needs and preferences of chronically ill and disabled elderly and their families has not been formally examined. Assessing in detail the care of such clients, from their perspective and the caregiver's perspective, can provide unique information about the provision of services to this needy and vulnerable population. Assuring quality in the provision of care has now become a pivotal aspect of service delivery. Adult day care is one such program that has not been adequately assessed for its quality of care as defined by users. A study on consumer perceptions of adult day care responds to an immediate need for data that currently do not exist. The purpose of the proposed project is to gain insight into the quality of care and user satisfaction with adult day care. This pilot study is a first step towards generating themes pertinent to quality and satisfaction from the user's perspective. The data obtained in this study will lay the groundwork for systematic measurement of quality care and factors that constitute user satisfaction with adult day care services. This project will employ a user-centered approach to elicit aspects of the ADC experience that are most salient to clients and their caregivers. The project will utilize focus group interviews to explore aspects associated with user needs, preferences, and satisfaction with adult day care centers. This information will then guide the development of a consumer-based methodology that ADCs ultimately employ to collect data efficiently and systematically from large numbers of care recipients and caregivers throughout the United States. Data on what participants and family members look for in adult day care will guide providers and policy makers in optimizing community-based services for older adults and their families. This information can support quality monitoring, evaluation, and improvement initiatives and can ultimately enhance functional and health outcomes.